How is urethral stricture treated?

The treatment will be decided by the findings on the imaging procedures. Treatment options include:

  • Urethral dilatation.
  • Internal urethrotomy.
  • Urethral reconstruction.

With a short stricture, urethral dilatation or internal urethrotomy may be tried first. Under general anesthesia, the urethra is widened using a series of gradually larger dilating instruments and a cystoscope. A urethrotomy is when the cystoscope is used to cut a ring of scar tissue with a small knife to enlarge the area of blockage.

After the procedure, an indwelling catheter is usually left in place for 3 to 5 days. “Indwelling” means inside the body. The most common problem of dilatation/urethrotomy is the return of the stricture. You can expect blood in the urine for a period of time after this or any procedure on the urinary tract.

When dilatation/urethrotomy fails and the stricture returns, urethral reconstruction may be needed to try to get more lasting result in terms of creating enough passage through the urethra. In some cases, the urethra is reconstructed by removing the scar tissue and then suturing the ends of the urethra back together, called an urethroplasty. When this is not possible, the urethra may be rebuilt using the lining of the inside of the cheek or skin flaps from the penis or scrotum. Using these methods, the urethra can be reconstructed in most cases with a good long-term success rate.

Last reviewed by a Cleveland Clinic medical professional on 07/23/2014.

References

  • Wong SS, Aboumarzouk OM, Narahari R, O’Riordan A, Pickard R. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men. Cochrane Database Syst Rev 2012; Dec 12;12:CD006934. doi: 10.1002/14651858.CD006934.pub3.
  • Luman N, Oosterlimck W, Hoebeke P. Urethral reconstruction using buccal mucosa or penile skin grafts: systematic review and meta-analysis. Urol Int 2012;89:387-394.
  • Mundy AR. Management of urethral strictures. Postgrad Med 2006;82:489-493.

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